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The Relative Burden of Dry Eye in Patients’ Lives: Comparisons to a U.S. Normative Sample

¹From Mapi Values, Boston, Massachusetts; ²Mapi Values, Cheshire, United Kingdom; ³Alcon Laboratories, Fort Worth, Texas; ⁵Clinical Trial Consultant, Atlanta, Georgia; the ⁶University of Alabama, School of Optometry, Birmingham, Alabama; ⁷Private Practice, Toronto, Ontario, Canada; ⁸Southern California College of Optometry, Fullerton, California; the ⁹University of Waterloo, School of Optometry, Waterloo, Ontario, Canada; the ¹⁰University of Minnesota, School of Medicine, Minneapolis, Minnesota; and ¹¹Indiana University, School of Optometry, Bloomington, Indiana.

PURPOSE. To assess the relative burden of dry eye in daily life by comparing Short Form-36 (SF-36) responses from individuals with and without dry eye against U.S. norms.

METHODS. Assessment of 210 people, 130 with non-Sjögren’s keratoconjunctivitis sicca (non-SS KCS), 32 with Sjögren’s Syndrome (SS), and 48 control subjects. The study population data and published normative SF-36 data were compared. Dry eye severity was assessed by recruited severity (control, non-SS KCS, SS), patient self-report (none, very mild/mild, moderate, severe/extremely severe), and clinician-report (none, mild, moderate, severe). Age- and gender-matched norms were compared with all defined severity groups.

RESULTS. Compared with the norms, control subjects scored higher on all SF-36 scales. Effect size (ES) ranged from 0.15 to 0.52. Non-SS KCS patients had lower Role-Physical (ES = –0.07), Bodily Pain (ES = –0.08), and Vitality (ES = –0.11) scores, indicating more dry eye impact on those areas versus the norm. All SF-36 scale scores except Mental Health (ES = 0.12) were lower in the SS group than the adjusted norm (ES range: –0.16 to –0.99). Regardless of severity classification, mild patients consistently had lower Role-Physical and Bodily Pain scores than the norm, suggesting impact on daily roles (ES < 0.2). Patients with moderately severe disease also experienced less vitality and poorer general health. The group with severe disease scored lower than the norm across all domains (ES range: –0.14 to –0.91) except Role-Emotional (ES = 0.13) and Mental Health (ES = 0.23).

CONCLUSIONS. These results indicate dry eye’s negative impact on everyday life, particularly in daily activities. Further research using disease-specific measures to examine dry eye’s impact is underway.

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